The Human Papillomavirus (HPV) is a highly common virus, and both skin tags and warts are frequent benign skin growths. Because they appear as small, fleshy bumps, people often confuse them and question whether HPV, the virus responsible for warts, might also cause skin tags. This article clarifies the unique origins of each growth and provides distinct characteristics for proper differentiation. Understanding their separate causes is helpful for determining risk factors, contagiousness, and appropriate management.
The Nature and Causes of Skin Tags
Skin tags, medically known as acrochordons, are small, benign skin tumors that are soft, flesh-colored, or slightly brown. They are typically attached to the skin surface by a slender stalk, known as a peduncle. Skin tags are composed of a core of loose collagen fibers and blood vessels covered by an outer layer of epidermis.
The primary cause of skin tags is mechanical friction, where skin repeatedly rubs against skin or clothing. This explains why they commonly appear in skin folds, such as the neck, armpits, groin, under the breasts, and on the eyelids. Skin tags are non-infectious and are not caused by a contagious agent like a virus.
While friction is the main driver, other systemic factors contribute significantly to their development. Skin tags are associated with metabolic syndrome conditions, including diabetes, insulin resistance, and obesity. High levels of circulating insulin and growth factors stimulate the hyperproliferation of skin cells and connective tissue. Hormonal changes, such as those experienced during pregnancy, also increase the likelihood of developing skin tags.
HPV and the Development of Warts
Warts are distinct skin lesions caused exclusively by infection with the Human Papillomavirus, an extremely common DNA virus. The virus enters the skin through tiny cuts or abrasions and infects the basal layer of the epidermis. The viral DNA then directs the cells to reproduce rapidly, leading to a localized overgrowth of the outer skin layer, known as hyperkeratosis.
There are over 200 different types of HPV, and specific strains cause different kinds of warts. Low-risk types like HPV 2 and 4 commonly cause rough, dome-shaped common warts on the hands and fingers. Other strains, such as HPV 6 and 11, cause genital warts and are classified as low-risk due to their low potential for causing cancer.
Warts are highly contagious because they are a manifestation of a viral infection. They transmit through direct skin-to-skin contact. The incubation period can vary significantly, sometimes taking weeks or months for the lesion to become visible after initial viral exposure.
Distinguishing Skin Tags from Warts
The most fundamental difference lies in their origin: warts are caused by a viral infection, while skin tags are non-viral growths driven by friction and metabolic factors. Although HPV is not the sole cause of skin tags, some studies have detected low-risk HPV DNA (types 6 and 11) within the tissue of some skin tags. This suggests HPV may act as a cofactor in certain cases.
Visually, the texture and surface of the growths offer reliable clues for differentiation. A skin tag is typically soft, smooth, and easily movable, often resembling a small balloon hanging from the skin. In contrast, a wart is generally firm, has a rough, irregular, or “cauliflower-like” surface, and usually has a broader base rather than a thin stalk.
The internal structure also provides an identifying feature upon close inspection. Warts, particularly common and plantar types, often display tiny black or dark red specks. These specks are minute blood vessels that have clotted, or thrombosed. Skin tags are usually a uniform skin color or slightly darker and do not contain these distinctive thrombosed capillaries.
If a growth is confusing or changes in appearance, a professional diagnosis is advisable. Any skin lesion that rapidly increases in size, changes color, begins to bleed without trauma, or becomes painful should be evaluated by a healthcare provider. While both skin tags and warts are generally harmless, a medical professional can confirm the nature of the growth and rule out other concerning conditions.